EXPERIMENTAL PRODUCTION OF ACUTE GASTRIC ULCER 



IN THE GUINEA-PIG.* 



By M. E. Rehfuss. 



It is here proposed to describe somewhat more in detail the results of our 

 experiments and to give a very short resume of the contributions by some au- 

 thors bearing on the formation of hemorrhagic erosions and acute gastric ulcer 

 of the stomach. This was the most typical lesion found in guinea-pigs which 

 succumbed to the venom of Heloderma. The fact that little is known as to the 

 pathogenesis of hemorrhagic erosions and the possibility of their development 

 into typical gastric ulcer increases the importance of this work. The researches 

 of Gay and Southardf on serum anaphylaxis, of Bolton J on gastrotoxic serum, 

 and of Rosenau and Anderson! on production of gastric ulcer and hemorrhage 

 by the subcutaneous inj ection of diphtheria toxin into guinea-pigs, together with 

 the exhaustive anatomical study by Beneke of hemorrhagic erosions occurring 

 in the human stomach, represent the most important contributions relating to 

 this problem. 



At a recent meeting of the German Association of Pathologists in Kiel, 

 Beneke ^[ called attention to the frequency of hemorrhagic erosions and cited 

 400 cases which he had collected. He pointed out the possibility of their de- 

 velopment into typical gastric ulcer. He says surgeons have frequently, within 

 the last ten years, noticed the occurrence of hemorrhage in the stomach as 

 evinced by the so-called "black vomiting " and even occasionally death. Ana- 

 tomically, hemorrhagic erosions of Cruveilhier are found in such cases, and 

 frequently associated with them are punctate ulcers. 27 per cent of Beneke's 

 collected cases were post-operative, the great majority having been observed 

 after intraperitoneal operations. He claims the danger in their formation is 

 the greater the more the field of operation approaches the ductus choledochus 

 and cceliac ganglion. The remainder of cases were found in a great variety of 

 diseases. From a morphologic point of view, he classifies his cases as follows: 

 (1) Typical hemorrhagic erosions. (2) Typical ecchymoses without ulcer. 

 (3) Simple ulcer, origin doubtful. (4) Ulcer plus ecchymoses. (5) Parenchy- 

 matous ecchymoses and apparent anatomical changes of the stomach. 



Beneke believes that the lesion is a primary digestion; that hemorrhage is 

 secondary, and that the origin of but a small proportion is in ecchymoses. In 

 order that digestion may take place, some special injury to the mucosa must 

 occur, and this usually is brought about through a lack of oxygen. For in- 



*A preliminary report of this work was published in the University of Pennsylvania Medical Bulletin. 1909. 



tJourn. Med. Research, July 1908., vol. xrx, 



tProceed. Roy. Soc, 1905-1906, series B, 77, p. 426; series B, 79, 1909. 



Journ. Infect. Diseases, 1907. UVerhandl. d. deutsch. Path. Gesellsch., Kiel, 1908. 



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